| NPI | 1942635578 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 060569) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AR PD08729) |
| 183500000X Pharmacist (Licence: FL PS50277) | |
| Enumeration Date | 2013-09-13 |
| Last Update Date | 2024-04-02 |